A report published in the academic journal Neurology examined individuals who had a stroke to determine whether they had the warning signs of a stroke prior to the acute stroke.  They found that the vast majority of strokes came without any warning.

The warning signs of a stroke are the same as stroke symptoms, but they come and go over a brief period of time. Typically, this is called a mini-stroke or a Transient Ischemic Attack (TIA). The study found that only 1 in 8 patients, about 12 percent, had a mini-stroke prior to the onset of the acute, full-blown stroke.

The data indicate that those with ischemic stroke were more likely to have a TIA than those with a hemorrhagic stroke (15 percent to 4.6 percent). 

"Of course we should always intervene if someone has had a warning event and try to sort out whether it's heralding a stroke to come or something else," said lead researcher Dr. Daniel G Hackam of the University of Western Ontario, London in an interview. "But we'll get more bang for our buck and be able to prevent more strokes if we were to devote more resources to primary prevention and actually trying to develop better tools to predict who will and who will not have a stroke in the future." 

The study was published in the September 29th issue of Neurology.

An ischemic stroke is the most common type of stroke and occurs when a blood vessel to the brain is blocked, depriving that part of the brain of oxygen and resulting in the permanent death of brain tissue.
 
The blockage can be caused by any of the following: 

-  Complete blockage of a large artery, most often a carotid artery (artery in the neck that brings blood to the brain).  The blockage is caused by the buildup of plaque on the inside of the artery, which “hardens” and narrows the artery.  This means the artery is diseased and not healthy. Another word for this is narrowing is “stenosis.”
 
-  The blockage of arteries in the brain caused by plaque from a diseased carotid artery breaking off and traveling to the smaller blood vessels within the brain or the movement of a clot from the heart in patients with atrial fibrillation to the blood vessels leading to or within the brain
 
A hemmorhagic (also called lacunar) stroke occurs when there is bleeding within the brain. Although this can occur from a number of causes, the overwhelming number are caused by high blood pressure (hypertension).
 
Life Line Screening looks for all three of the major causes of stroke – carotid artery stenosis, atrial fibrillation, and high blood pressure.

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